Miriam Beth Shabazz, LICSW

NPI #1902399090 in Jamaica Plain, Massachusetts

Provider Information

NPI Number: 1902399090
Entity Type: Individual
Name: Miriam Beth Shabazz, LICSW
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Social Worker - Clinical
Credential: LICSW
Enumeration Date: Jun 13, 2018
Last Updated: Jun 13, 2018

Practice Location

Address: 150 S HUNTINGTON AVE
City: Jamaica Plain
State: Massachusetts
ZIP Code: 02130-4817
Phone: (857) 364-6311

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X	Primary

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